Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $74.13 / $75.86	Facility	26	$72.44	$74.13	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $416.87	Professional		$123.03	$169.82	$416.87
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $51.29 / $123.03	Professional	26	$38.90	$51.29	$123.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $117.49 / $165.96	Professional	TC	$89.13	$117.49	$165.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $281.84	Professional		$112.20	$131.83	$281.84
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $47.86 / $72.44	Professional	26	$35.48	$47.86	$72.44
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $83.18 / $165.96	Professional	TC	$72.44	$83.18	$165.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Professional		$229.09	$229.09	$229.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Professional	26	$74.13	$74.13	$74.13
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	TC	$158.49	$158.49	$158.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $117.49 / $229.09	Professional		$45.71	$117.49	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $213.80 / $323.59	Professional		$144.54	$213.80	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $67.61 / $97.72	Professional	26	$44.67	$67.61	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $147.91 / $218.78	Professional	TC	$97.72	$147.91	$218.78
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $263.03 / $281.84	Professional		$229.09	$263.03	$281.84
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $79.43 / $83.18	Professional	26	$77.62	$79.43	$83.18
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	TC	$190.55	$190.55	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $190.55 / $295.12	Professional		$147.91	$190.55	$295.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $57.54 / $93.33	Professional	26	$44.67	$57.54	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $131.83 / $204.17	Professional	TC	$102.33	$131.83	$204.17